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Quality and standards of care in all medical specialisms differ significantly across the country. There are over 300 NHS Hospital Trusts, effectively operating independently and responsible for their own budgets and delivery of care, albeit within an overarching framework. This means that when quality and safety improvements are made in a urological service in one NHS Trust, there are no effective means of sharing and implementing these improvements and knowledge across the service, to the detriment of urology patients.

The confidence and the tools to challenge and question practice and offer alternative solutions.

The ability to approach problems and mistakes on a ‘no blame’ basis in order to seek real improvements to services and processes.

Leadership skills to be able to implement and drive change across their organisations and beyond.

Embedding these skills in trainees provides the opportunity to deliver the culture shift needed in the NHS towards a proactive approach to improving clinical care and a more open culture that acknowledges errors and omissions when they happen, discusses them robustly, and reflects on them in a manner that leads to real practical improvement. These skills can then be used throughout their careers as consultants.